Post Traumatic Stress Disorder

   A person’s response to a traumatic event may vary in the number of symptoms experienced, their intensity, and duration. Stress reactions are very common and may range from general feelings of confusion and fear to more specific symptoms of sadness, guilt, anger, depression, anxiety and social withdrawal. In their most severe form, symptoms can group together to form a condition known as Acute Stress Disorder (ASD) if they occur within the first four weeks post-trauma, or Post-Traumatic Stress Disorder (PTSD) if they persist for longer than one month. These conditions require professional assistance and treatment.

   The following description of PTSD is merely an outline of the major groups of symptoms that clinicians look for when diagnosing the condition.

• The person must have experienced, witnessed or confronted with a traumatic event that involved a threat to the physical well-being of themselves or others.

• The person has reacted to that event with intense fear, helplessness or horror.

• The person is experiencing distressing recollections and flashbacks of the trauma. Symptoms may include repetitive thoughts and images, repeated upsetting dreams and nightmares, feeling as though the trauma is happening all over again, and intense distress when faced with reminders of the trauma.

• Avoidance and numbing of emotions is experienced. Symptoms may include, avoiding talking or thinking about the trauma, avoiding people, places or activities that remind them of the trauma, feeling detached from others, low mood and loss of interesting usual activities, and feeling a sense of foreshortened future.

• Symptoms of increased levels of physical arousal also need to be present. These may include, sleep disturbances, irritability, difficulty concentrating, easily startled by noise, restlessness, muscle tension, trembling or shaking, palpitations, shortness of breath and dizziness.

   These symptoms can become severe if left untreated for long periods of time. If you notice any of these or other reactions that may be concerning you please seek professional assistance.

   Many people find that their psychological reactions to a trauma begin to subside after a few weeks. However, some symptoms persist and can be very disturbing for the person and their loved ones. If your symptoms have not substantially subsided after about four weeks it is recommended that you seek professional assistance to try to prevent any long-term problems. Research indicates that the majority of symptoms remit by about three months after a trauma.

   The following indicators will help you determine whether to see someone for assistance:

• you are unable to handle the intense feelings or physical sensations;
• you continue to feel numb and empty and do not have normal feelings;
• you feel your emotions are not returning to normal over a period of time;
• you continue to have physical symptoms;
• you continue to have nightmares and disturbed sleep;
• you have no persons or group with whom you can share your emotions;
• your relationships and work seem to be suffering or changing as a result of the trauma;
• you are having accidents as a result of poor concentration
• You are increasing the use of alcohol and drugs (for example sleeping tablets).

   Many people find it difficult to ask for help, especially when they feel they should be able to cope on their own and feel ashamed to accept assistance. The importance of seeking treatment for persistent psychological reactions cannot be stressed enough. There are many health professionals who have been especially trained to deal with post-traumatic stress and who are sensitive, supportive and very understanding. You do not need to feel ashamed, guilty or weak at asking for help. You have a right to seek help if you need it.

   There are social workers who are members of the trauma team specialising in the psychological, social and legal aspects of trauma care. At Liverpool Hospital the social workers in the Emergency Department, Intensive Care and Trauma Ward work with patients and/or family members through the initial crisis and recovery period. The social worker provides information about practical and legal services.

After Hospital Treatment

• Your local medical officer (family doctor) can refer you for appropriate treatment, including helping you access mental health services.
• Community Health Centres offer a range of psychological and counselling services; the telephone number of your local centre can be found under ‘C’ in the white pages telephone directory; ring after 1pm and speak to the intake worker; this service is free and confidential.
• Psychologists and counsellors in private practice can provide treatment and write medico-legal reports if required; look under ‘P’ and ‘C’ in the yellow pages telephone directory.

   The Psychiatry Research and Teaching Unit at Liverpool Hospital can provide psychological assistance to the survivors of trauma, particularly motor vehicle accidents; telephone (02) 9828 4912/4902; this is a free service.

   There is a Post Traumatic Stress Disorder Unit at Westmead Hospital, providing a free psychological service for victims of crime, accident or other traumatic events; telephone (02) 9845 7979.

   Help is also available at the Clinic for Anxiety and Traumatic Stress at Bankstown Hospital. This is a free service for people suffering a range of anxiety disorders and traumatic stress. Phone: (02) 9722 8992

   There are specialist counselling services for some specific events; contact the following numbers for appropriate treatment and referral:

• If you are not sure what you need or you just want to talk, ring Lifeline on 13 1114.

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